HomeMy WebLinkAbout0014899-Electric (rewire) CITY OF OSHKOSH N9 14899
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ir PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS e JT/ ✓ - - PLAN NO.
OWNER a> arZ-el(cock°
DESIGNER
USE /NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR t�
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches X Receptacles Circuits / /
4;:)
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
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FEES: Valuation $ fi � / t (J 0 "- Permit Fee Paid $ � C-/ Park Dedication $
II
ISSUED BY ' - %.;/ �
Date Z, Final /O.P. 7 --- cf? . .„5 -
i
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 2.
'' .Z�i� �✓ G / 7 — 2 7
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. / "C (-2 7 / . • -PL.
. CONTR.
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OWNER 47rel
ADDRESS �-�
NATURE OF WORK
ZiLEC. SERV. NEW CHANGE D TEMP .
DESC. TYPE 3 - ! n`` VOLTS Le CJ AMPS /d C
FIX'S SW S RECEPT' S S
APPLIANCES 1
S IGNS , � ����"r�
INSP. ROUGHIN SERVICE ( -1 / FINAL `<' - ?
EST. COST !Ef ✓7 p / J PERMIT FEE 5 DATE PD...?" ?-
REMARKS